Summary: | The Community Tracking Study (CTS), a project of
the Center for Studying Health System Change (HSC), is a large-scale
longitudinal investigation of health system change and its effects on
people. Designed to track a cohort of American communities at two-year
intervals beginning in 1996, this major research effort, sponsored by
The Robert Wood Johnson Foundation (RWJF), gathers information to
monitor and understand the evolution of health care in the United
States. CTS is investigating the ways in which hospitals, health
plans, physicians, safety-net providers, and other provider groups are
restructuring their systems, and the forces driving the organizational
changes. Additionally, the project tracks health insurance coverage,
access to care, use of health services, health care costs, and
perceived quality of health care. Sixty sites (51 metropolitan areas
and 9 nonmetropolitan areas) were randomly selected to form the core
of CTS and to be representative of the nation as a whole. Much of the
information collected by CTS comes from nationally representative
surveys of households, health plans, and physicians conducted by
HSC. The Household Survey is administered to households in the 60 CTS
sites, plus a supplemental national sample of households, covering
some 60,000 individuals. A survey of health plans, the Followback
Survey, elicits detailed information on private health insurance
coverage reported in the Household Survey from organizations that
offer or administer private health insurance policies in the CTS
sites. The Physician Survey interviews physicians in the 60 CTS sites
and a supplemental national sample of physicians. RWJF has built a
network of research organizations that are studying various facets of
the changing health care system, some of which are simultaneously
examining the CTS communities. Stephen H. Long and M. Susan Marquis at
RAND conducted an employer survey (Robert Wood Johnson Foundation
Employer Health Insurance Survey [Community Tracking Study and State
Initiatives in Health Care Reform Program], 1997) with a special
emphasis on the 60 CTS sites. At UCLA and RAND, Kenneth B. Wells,
Audrey Burman, and Roland Sturm are examining how public policies and
markets are affecting access to substance abuse and mental health
services. Their survey, National Survey of Alcohol, Drug, and Mental
Health Problems [Healthcare for Communities], 1997-1998, reinterviewed
some 9,600 respondents from the CTS Household Survey about their
health and daily activities, use of alcohol, illicit drugs, and
medications, health insurance coverage and coverage for mental health,
plus access to, utilization, and quality of behavioral health
care. |
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